This renewal application proposes a plan to sustain and enhance a unique training program in an emerging area of trans-disciplinary research, co-occurring substance use and other psychiatric and medical disorders (COD). The need for this scientific focus is vital given that COD are more the norm than the exception among those with addictive disorders. The philosophy of this program charges that to effectively impact the problems of addiction and other common psychiatric and health disorders, one must be fully aware of their co-existence, etiologies, phenomenology, and clinical manifestations. Our evolving program leverages unique resources and opportunities available at Dartmouth. Five diverse research groups (Center for Technology and Behavioral Health, Department of Psychological and Brain Sciences, Norris Cotton Cancer Control Research Program, the Department of Psychiatry?s Addiction Research Program, and the Program of Experimental and Molecular Medicine-Neuroscience) provide COD-focused opportunities in behavioral and neurobiological mechanisms, behavioral and pharmacological treatment development, technology-assisted innovations in assessment and treatment delivery, implementation science, and health services and policy. Training faculty include MD and PhD investigators with strong histories of training young scientists and outstanding records of extramural funding to support their research programs. Currently our T32 faculty have 24 NIH-, 3 NSF-, and 1 PCORI- funded projects. During the first 4 years of this program (the initial cycle of funding), our training slots have remained at capacity with high quality trainees, and we have now trained or are in the process of training 4 predoctoral and 7 postdoctoral T-32 funded trainees and two other trainees who participated in our program but were funded by other sources. These trainees have authored 75 peer-reviewed publications related to their training activities and were first author on 45% of these. Our trainees have presented their research at many national and local scientific conferences, and all but two have completed capstone projects in a secondary area of interest with an alternative mentor. All the trainees who have or are about to complete the program continue in research intensive positions or have continued in the next step of research training towards becoming independent research scientists. Our evaluation process has yielded highly positive feedback, and also resulted in planned enhancements to our training program. This renewal application proposes to maintain an active census of 3 predoctoral and 4 postdoctoral trainees. We have developed a revised a recruitment plan that takes advantage of new Dartmouth initiatives to address our continued difficulty attracting and enrolling underrepresented minorities to the program. Overall, the first cycle of T32 funding has resulted in the successful development and implementation of a vigorous training program that is effectively preparing young scientists to engage in collaborative and transdisciplinary research that embraces and addresses the co- existence of addiction and other psychiatric and health disorders.